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Definition

Natural hormone replacement therapy (NHRT) is the use of non-synthetic, bio-identical hormones (estrogens, progesterone, and/or testosterone), derived from plants), to treat hormone imbalances and deficiencies. The first oral contraceptive pill was originally derived from Dioscorea species, wild yam; later soy was used as the precursor for oral contraceptive hormones.

Origins

Chinese medicine has made use of phytohormones for thousands of years. Natural progesterone was first crystallized from plants in 1938. NHRT was developed in the late 1970s and became available commercially in the early 1980s. By 1989 micronized (very finely ground) progesterone was developed for better absorption into the bloodstream. The use of NHRT has increased as women have become increasingly dissatisfied with conventional hormone replacement therapy (HRT) because of ineffectiveness, side effects, and/or growing concerns about risks, especially breast and uterine cancer risk.

Benefits

NHRT often alleviates symptoms of hormone imbalances and deficiencies that may occur at any stage of life after puberty. In particular, NHRT is used to support hormone balance in the body during and after menopause, when estrogens, progesterone and testerone decline. It also is used in men to treat andropause that often affects middle-aged men as testosterone levels fall. Menopausal and andropausal symptoms often subside within months to years without any treatment. The symptoms also often improve after one to three months of NHRT use.

Low levels of estrogen, progesterone, and testosterone may be associated with chronic diseases of aging.

Some researchers claim that NHRT may slow the aging process and help prevent:

  • fibroblastic or lumpy breasts
  • heart disease
  • osteoporosis
  • cancer

Reported benefits of testosterone NHRT therapy in men include:

  • increased muscle mass and lower body fat
  • increased sex drive
  • increased energy levels
  • improved concentration and productivity

Human sex hormones

The major steroid sex hormones—estrogen, progesterone, and testosterone—control gender and the aging process. They help maintain health and have profound effects on emotions and behavior. Cells throughout the body have receptor molecules on their surfaces that bind specific hormones. Receptor-binding causes a series of reactions within the cell that are specific for the hormone and cell type.

In the human body cholesterol is converted into pregnenolone, which is converted into both progesterone and dehydroepiandrosterone (DHEA). These hormones, in turn, can be converted into estrogens, testosterone, and other hormones.

High levels of sex hormones are produced in the developing fetus and then almost disappear until puberty. Estrogen and progesterone are at high levels during the reproductive years and are extremely high during pregnancy. With aging, the levels of sex hormones decline. When ovulation ceases at menopause, progesterone production drops to very low levels. Estrogen and progesterone have opposing effects in the body, balancing each other. At various times in their lives, many women experience hormone imbalances or sudden changes in hormone levels. During menopause the ratio of estrogen to progesterone may increase. During andropause the ratio of testosterone to estrogen may decline.

Although the body produces many forms of estrogen, the term usually refers to the three major types:

  • Estriol is the weakest estrogen.
  • Estradiol is the most active estrogen. Nearly every cell in the body has estradiol receptors, making it extremely important for cell and organ function.
  • Estrone is made from testosterone derivatives in fat cells of postmenopausal women.

The body also produces several different types of testosterone.

NHRT hormones

The hormones used in NHRT are considered to be "bioidentical" to human sex hormones. The chemical formulae of NHRT hormones are identical to the corresponding hormones produced in the human body. They are very similar or identical to human hormones in their chemical structures, modes of action, and interactions with cell-surface receptors and other hormones. Receptors do not distinguish between the body's own hormones and natural hormones. Therefore natural hormones do not compete with endogenous hormones for receptor sites; rather they supplement and balance the endogenous hormones. In contrast, the synthetic hormones used in conventional HRT are processed and synthesized from chemicals or animal products and are not chemically or biologically identical to human hormones. Synthetic hormones can compete with or replace the body's own hormones because some receptors mistake them for endogenous hormones.

Prescription-strength natural hormones usually are produced from stigmasterol extracted from soybeans. They are chemically altered so as to be bioidentical to human forms such as progesterone or the human estrogens. Progesterone and testosterone may be micronized for NHRT. Over-the-counter (OTC) natural progesterone creams usually are derived from diosgenin extracted from the giant Mexican yam. NHRT hormones are manufactured for pharmaceutical companies that make standard-dosage medications and for compounding or formulating pharmacies that make up individualized medications.

Testosterone is often supplied as DHEA. Pharmaceutical-grade DHEA is available without a prescription.

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Author Info: Margaret Alic PhD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005
 
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